• Archives of Reconstructive Microsurgery
• /
• v.21 no.2
• /
• pp.111-117
• /
• 2012

Purpose: To report the clinical results of the perforated-based propeller flap for lower extremity soft tissue reconstruction. Materials and Methods: Between January 2010 and June 2012, a total of 16 defects in the lower extremities were covered with perforator-based propeller flaps. Retrospective data for location and size of the defect, flap dimension, pedicle artery, pedicle rotation, complications were obtained. Results: Peroneal artery-based perforator flap were used in eleven cases, posterior tibial artery-based perforator flap in two cases, anterior tibial artery-based perforator flap in one case and medial plantar artery-based perforator flap in two cases. The average size of the flaps was $63cm^2$. The marginal skin necrosis of the flaps as a complication was developed in two cases, one of which was covered with split-thickness skin graft. There were no functional deficits from the donor site. Conclusion: For the reconstruction of lower extremities, the perforator-based propeller flap could be a reasonable alternative as it is a simple, safe and versatile technique.

• Archives of Reconstructive Microsurgery
• /
• v.13 no.2
• /
• pp.117-122
• /
• 2004

Purpose : The aim of this study was to evaluate the efficacy of arterialized venous flap in finger flexion contracture correction. Materials and methods : From 2002 to 2004, we have performed 10 arteriaized venous flap for treatment of severe flexion contracture in digit. The duration of flexion contracture was from 1 year to 50 years. The cause of contracture were bum scar(7 cases), postoperative contracture(2 cases) and other(l case). We evaluated the survival of flap, flap size, recovery of flexion contracture and subjective satisfaction. Results : All arterialized venous flap survived. The marginal minimal skin necrosis developed in 2 cases. The flap size was average $5.2{\times}3.5cm$. The recovery of flexion contracture was 87% compared with non affected side. 9 patients(90%) satisfied the results of operation. Conclusion : Arterialized venous flap is one of the useful procedure in treatment of finger flexion contracture because it has many advantages such as thin and good quality, variable length of pedicle, preservation of major vascular pedicle, less operation time and in addition possibility of various modifications.

• Archives of Reconstructive Microsurgery
• /
• v.5 no.1
• /
• pp.62-69
• /
• 1996

Lateral arm flap has been used for the reconstruction of the various defects in hand, head and neck region. This flap is highly dependable as a free flap because of its thin flap thickness, constant vascular anatomy and possibility of osteocutaneous flap and fascial flap. Recently, many authors tried extended approach for vascular pedicle and distal flap extension for bigger defects. In this study, we review previous articles and 14 cases used lateral arm flaps for coverage of the varying defect on head and neck, upper and lower extremities succesfully. In conclusion, lateral arm flap has constant anatomical structure and can overcome the disadvantages such as short pedicle length and limited flap size, then the range of its application can be very widened.

• Journal of Animal Science and Technology
• /
• v.48 no.6
• /
• pp.943-948
• /
• 2006

This study carried out to investigate the effect of cutting stimulation on time of cutting, yield and length of antler in Sika deer. There was no significance between surgical stimulation and length of antler, but length was the longest in one side cutting group and the shortest in both side cutting group. Development of point was increased as the number of wounds in the second year (P<0.05). Time of casting was 2 weeks earlier in one side cutting group (P<0.05) than in both sides cutting group. Yields of velvet antler were 148±23g when pedicle was not cut, and 126±61g, 179±63g, 170g, and 48±25g when pedicle was cut by 0.3cm, 0.4cm, 0.5cm and 0.6cm thickness, respectively. In case of 0.6cm, yield was significantly smaller than others (P<0.05). The most desirable thickness of pedicle cut was 0.4～0.5mm. Yield of antler was increased as the size of wound in the first year, and 588, 790 and 657g in control, one-cut and both-cut, respectively. Yields of antler in one-cut is significantly high (P<0.05).

• Archives of Reconstructive Microsurgery
• /
• v.8 no.2
• /
• pp.139-148
• /
• 1999

Since Nakayama's first report about venous flap, many experimental and clinical studies were done about this new type of flap. And due to its various benefits, its applications as arterialized venous free flap type have increased recently. In this study we have attempted to reconstruct composite of defects of the hand with new modification of arterialized venous free flap and simultaneous reconstruction of skin, nerve, tendon were performed successfully. From 1994 to 1999, the defects of the hands in 35 patients were reconstructed with various modifications of arterialized venous free flaps. The range of age was from 19 to 55 years and size of flap ranged from $1{\times}2cm\;to\;14{\times}9cm$. Among them, 12 cases of flap over 20cm in size were included. Indications of flaps were as follows: resurfacing of the defects of the skin (9 cases), simultaneous reconstruction of extensor, skin and digital nerve(2 cases), reconstruction of the skin with extensor(5 cases), as a flap-through type vascular reconstruction(6 cases), for digital nerve reconstruction(2 cases), contracture release(3 cases), and finger tip reconstruction(9 cases). All of the cases except one survived with marginal skin necrosis less than 10%. And relatively large flaps over 20cm in size successfully survived without any delay procedures. Composite reconstructions including tendon and nerve were successful with new modifications of this flap. Arterialized venous free flap is one of the useful procedure in reconstruction of the hand because it has many advantages such as non-bulky and good quality of flap, variable length of pedicle, preservation of major vascular pedicle, less operation time, single operative field and in addition possibility of various modifications.

• Journal of Chest Surgery
• /
• v.23 no.5
• /
• pp.994-997
• /
• 1990

We are reporting a case of esophageal hemangioma, which is a very rare disease with only 24 cases having been reported. A 31-year-old male with dysphagia was shown to have a hemangioma of the upper thoracic esophagus and resection of the lesion cured this problem. Once diagnosed in symptomatic patient, treatment should be instituted because of followings; 1. growth potency to large size, 2. possible complications such as hemorrhage and obstruction, and 3. exclusion diagnosis of malignancy. Surgery is the treatment of choice due to its effectiveness and safety, but endoscopic removal may be possible for small tumors and those on a pedicle.

• Archives of Plastic Surgery
• /
• v.42 no.1
• /
• pp.73-77
• /
• 2015

The latissimus dorsi flap is popular due to the versatile nature of its applications. When used as a pedicled flap it provides a robust solution when soft tissue coverage is required following breast, thoracic and head and neck surgery. Its utilization as a free flap is extensive due to the muscle's size, constant anatomy, large caliber of the pedicle and the fact it can be used for functional muscle transfers. In facial palsy it provides the surgeon with a long neurovascular pedicle that is invaluable in situations where commonly used facial vessels are not available, in congenital cases or where previous free functional muscle transfers have been attempted, or patients where a one-stage procedure is indicated and a long nerve is required to reach the contra-lateral side. Although some facial palsy surgeons use the trans-axillary approach, an operative guide of raising the flap by this method has not been provided. A clear guide of raising the flap with the patient in the supine position is described in detail and offers the benefits of reducing the risk of potential brachial plexus injury and allows two surgical teams to work synchronously to reduce operative time.

• Archives of Reconstructive Microsurgery
• /
• v.13 no.1
• /
• pp.29-35
• /
• 2004

Materials and Methods: Total number of peroneal perforator flap is 14 cases, which 10 cases were man, 4 cases were woman. The range of age was 12 years old minimally and until 63 years old. The trauma was most common etiology, which was like traffic accidents, 9 cases. We confirmed tibialis anterior artery patency by doppler flow meter, angiography as preoperative evaluation. Results: 1. The success rate was 91%, that in 14 cases, 13 cases were succeded. 2. To obtain successful result of peroneal flap, one must have the anatomic concept for vascular pattern, 8 cases were between peroneus muscle and soleus muscle branch type but, 3 cases were through soleus muscle branch type, so we treated these cases by using soleus muscle including peroneal perforating branch not to injury perforating artery directly. 3. The pedicle size was between minimally $2{\times}2.5cm$ and maximally $6.5{\times}8.5cm$ so we could treat large recipient site. 4. The pedicle length was between minimally 3.2 cm and maximally 11.5cm, average 7.5 cm. 5. The diameter of perforating artery was estimated by inspection, that was about 0.2-0.5 cm Conclusion: The peroneal perforating artery flap has merits that we can approach in avascular zone and has wide movable range from foot to distal femur and little donor site mobidity and can harvest osteocutaneous flap. The weak point was the irregular anatomy of nutrient artery and not to contain sensory nerve.

• Archives of Plastic Surgery
• /
• v.39 no.4
• /
• pp.360-366
• /
• 2012

Background Coverage of defects of the pretibial area remains a challenge for surgeons. The difficulty comes from the limited mobility and availability of the overlying skin and soft tissue. We applied variable pedicled perforator flaps to overcome the disadvantages of local flaps and free flaps on the pretibial area. Methods Eight patients who had the defects in the anterior tibial area were enrolled. Retrospective data were obtained on patient demographics, cause, defect location, defect size, flap dimension, originating artery, pedicle length, pedicle rotation, complication, and postoperative result. The raw surface created following the flap elevation was covered with a split thickness skin graft. Results Posterior tibial artery-based perforator flaps were used in five cases and peroneal artery-based perforator flaps in three cases. The mean age was 54.3 and the mean period of follow-up was 6 months. The average size of the flaps was 63.8 $cm^2$, with a range of 18 to 135 $cm^2$. There were no major complications. No patients had any newly developed functional deficit of the lower leg. Conclusions We suggest that pedicled perforator flaps can be an alternative treatment modality for covering pretibial defects as a simple, safe and versatile procedure.

• Korean Journal of Agricultural Science
• /
• v.33 no.2
• /
• pp.115-121
• /
• 2006

This study carried out to investigate the effect of cutting stimulation on time of cutting, yield and length of antler in Sika deer. There was no significance between surgical stimulation and length of antler, but length was the longest in one side cutting group and the shortest in both side cutting group. Development of point was increased as the number of wounds in the second year (P<0.05). Time of casting was 2 weeks earlier in one side cutting group (P<0.05) than in both sides cutting group. Yields of antler were $148{\pm}23g$ when pedicle was not cut, and $126{\pm}61g$, $179{\pm}63g$, 170g, and $48{\pm}25g$ when pedicle was cut by 0.3cm, 0.4cm, 0.5cm and 0.6cm, respectively. The most desirable thickness of pedicle cut was 0.4-0.5mm. Yield of antler was increased as the size of wound in the first year, and 588, 790 and 657g in control, one-cut and both-cut, respectively. Yields of antler in one-cut is significantly high (P<0.05).